Anti Mullerian Hormone (AMH) Test

AMH Test is done for :

• Evaluating ovarian reserve and responsiveness for infertility and assisted reproduction.
• Checking menopausal state, including early ovarian failure.
• Assessing infants with ambiguous genitalia and other intersex conditions.
• Assessing testicular function in males.
• Monitoring patients with antimullerian hormone-secreting ovarian granulosa cell tumours.
• Diagnosing menstrual disorders in women, such as PCOS.
• Assessing the cause of amenorrhea in girls older than 15 years or women with no periods for several months at a stretch

AMH test measures Anti-Müllerian Hormone (AMH) levels in serum.

AMH test requires a blood sample. A tourniquet (elastic) band is placed tightly on the upper arm. The patient is then asked to make a fist. This helps in the build-up of blood filling the veins. The skin is disinfected before needle insertion and the blood sample is collected in vacutainer.

• Menopausal women or women with premature ovarian failure of any cause, including after cancer chemotherapy, have very low anti-mullerian hormone (AMH) levels.
• AMH may be used as a surrogate to antral follicle count (AFC) at day 2 to 4 of the menstrual cycle to determine ovarian reserve.
• Women with an AFC greater than 15 are identified as having high ovarian reserve. 
• Values are high in women with PCOS.

The normal serum AMH level ranges between 2 and 6.8 ng/mL. A high level of AMH may be suggestive of PCOS. A low level of AMH may suggest:

1. The woman has a low ovarian reserve and may have difficulty conceiving.
2. The onset of menopause.
3. Women with premature ovarian failure on chemotherapy.
4. Low levels of AMH in male infants may indicate some genetic or hormonal issue, which can result in indistinguishable female or male genitalia.

On days 2 to 4 of the menstrual cycle, AMH levels can be used as a substitute for antral follicle count (AFC) to determine ovarian reserve. AMH values ranging from 2.19 to 4 indicate an AFC of 11-25. Women with an AFC of 15 or higher have a large ovarian reserve.

Along with the AMH test, a transvaginal ultrasound and hormone tests like estradiol and follicle-stimulating hormone (FSH) levels are often ordered. 

No special preparation, such as fasting, is required before the AMH test. However, it's important to consult with your healthcare provider before undergoing the test for any instructions.

On average, the AMH test costs between INR 1300 and 2750, depending on the lab.

The AMH test helps determine the fertility of a woman by estimating the number of egg cells she has. High AMH values mean there are more egg cells, and the woman has a high chance of conceiving. The AMH test aids in determining the success rate of assisted reproductive techniques such as in-vitro fertilisation in women seeking fertility treatment. 

Ambiguous genitalia is a congenital defect in which a baby's external genitalia do not have the typical appearance of male or female genitalia. In such cases, an AMH test along with genetic testing may be recommended to get more clarity about the infant's gender.

• Antimullerian Hormone
• Mullerian-inhibiting hormone (MIH)
• Mullerian inhibiting factor (MIF)
• Mullerian-inhibiting substance (MIS)

AMH test may be recommended for the following purposes:

• Difficulty conceiving.
• Determining success rate of fertility treatments such as in-vitro fertilisation (IVF).
• Showing symptoms of PCOS.
• Monitoring the effectiveness of ovarian cancer treatment.